Provider First Line Business Practice Location Address:
575 COAL VALLEY ROAD, SUITE 502
Provider Second Line Business Practice Location Address:
JEFFERSON REGIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-469-5983
Provider Business Practice Location Address Fax Number:
412-469-5946
Provider Enumeration Date:
02/26/2007